In November of 1944, Franklin Delano Roosevelt was reelected to a fourth term as president of the United States, an unprecedented, but not unexpected achievement for the New York businessman turned politician who garnered increasing support of the American people during his twelve years in the Oval Office.

Although a handful of past presidents had tried, none had served more than two terms, a limitation the nation’s first president General George Washington had advised others to follow. But at the time, there were no restrictions. FDR, as he was famously called, broke new ground when he won a third term. A fourth term he felt during a time of war was just as important.

The voting public agreed. Roosevelt, a Democrat, beat Republican challenger Thomas Dewey in what can be considered even by today’s standard as an overwhelming victory.

The voters, however, had no idea – at least not officially – that they had elected back into office a man who was living on borrowed time.

In the months, even years, leading up to the 1944 election, the American people heard rumors and speculation about the president’s health. Roosevelt suffered from polio which limited his mobility, but in 1944 his appearance seemed to worsen. He looked feeble and weak; his eyes were often red and swollen; and his movements were slow and calculated.

Dr,. Frank Lehay

Behind the scenes, there were concerns, but no immediate panic. Dr. Frank Howard Lahey, a respected surgeon known for opening a multi-specialty group practice in Boston, was brought in for a consultation. Lahey’s connection with the Navy’s consulting board led him to the White House. After a careful examination, Lahey informed Roosevelt that he was in advanced stages of cardiac failure and should not seek a fourth term. Even went so far as to warn Roosevelt that if he did win reelection, he would likely die in office. Roosevelt listened but did not follow Lahey’s advice. He felt it was his duty to continue.

In April of 1945, less than three months after being sworn in for the fourth time, Roosevelt was dead.

The president’s death took most Americans by surprise. That’s because shortly after being reelected, Roosevelt’s personal physician at the time, the surgeon general of the U.S. Navy, Dr. Ross McIntire, helped quell public fears by proclaiming FDR was feeling fine. But others could visibly see the president’s decline.

At the White House, Vice President Harry Truman was sworn in and questions were asked: Why didn’t the voting public know the truth about Roosevelt’s health?

In hindsight, Lahey’s report seemed to be the most truthful and forewarning. But information between a doctor and client is private and confidential. The White House only asked Lehay to consult the president. Whether the details were released was up to Roosevelt and his staff. The report was concealed and only came to light nearly six decades later. Lehay himself could have spoke up, but chose to remain silent and honor the patient-doctor confidentiality agreement.

Instead, what was disclosed to the public was mostly misleading. It included a glaringly deceptive assessment of the president’s condition in the months before the election.

In March 1944, the White House announced a report by Dr. McIntire, which claimed the 62-year-old Roosevelt was looking “tired and haggard” due to the stress and strain of the war years and nothing more.

“In my opinion,” McIntire added, “Roosevelt is in excellent condition for a man of his age.”